Therapeutic mammoplasty as a viable surgical approach in Breast Cancer Patients from India: A Single Institutional Audit

IntroductionTherapeutic mammoplasty (TM) is a type of oncoplastic breast surgery (OBS) well suited to breast cancers in medium-large sized breasts with ptosis, and in some cases of large or multifocal/Multicentric (MF/MC) tumors. It includes contralateral symmetrisation. This report describes our experiences and outcomes of TM in breast cancer patients in a single institutional cohort in India. MethodsWe present data for 207 cases (194 breast cancer, 13 benign disease) who underwent TM as part of their primary treatment. All patients underwent surgery after careful analysis of feasibility by a multidisciplanary tumor board and patient counselling. We report the clinicopathological profiles, surgical and oncological outcomes, and patient related outcome measures (PROMs) with different TM surgical procedures. ResultsPatients were relatively young at a median age of 49 years with moderate-large breasts and grade II-III ptosis. Patients underwent simple (n=96), complex (n=79) or extreme TM (n=46). Low post-operative complication rates and good-excellent cosmetic scores were observed. With median follow-up of 26 months, 148 patients completed more than 1 year follow-up. The 1-year BREAST-Q PROMs revealed good-to-excellent scores for all types of therapeutic mammoplasty. ConclusionWe conclude that in a country where women present with large and locally advanced tumours, TM safely expands the indications for breast conservation surgery. PROMs scores show that this surgery is perceived to be physically and mentally satisfactory. With the popularization of this procedure, it is possible that more Indian patients with breast cancer will receive the benefits of breast conservation while maintaining their quality of life.